SPE7M118Q0883.PDF

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Attached to: MOTOR, DIRECT CURREN Federal contract opportunity
Solicitation number: SPE7M118Q0883
Issued by: Defense Logistics Agency Land and Maritime

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REQUEST FOR QUOTATIONS THIS RFQ IS IS NOT A SMALL BUSINESS SET-ASIDE

4. CERT.FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG. 1

5. ISSUED BY

7. DELIVERY

9. DESTINATION

10. PLEASE FURNISH QUOTATIONS TO THE

ISSUING OFFICE IN BLOCK 5 ON OR

BEFORE CLOSE OF BUSINESS (Date)

IMPORTANT: This is a request for information, and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotations must be completed by the quoter.

11. SCHEDULE (See Continuation Sheets)

12. DISCOUNT FOR PROMPT PAYMENT

d. CALENDAR DAYS

NUMBER PERCENTAGE

NOTE: Additional provisions and representations are are not attached.

13. NAME AND ADDRESS OF QUOTER

a. NAME OF QUOTER

14. SIGNATURE OF PERSON AUTHORIZED TO SIGN

QUOTATION

16. SIGNER

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not useable

STANDARD FORM 18 (REV. 6-95)

Prescribed by GSA-FAR (48 CFR) 53.215-1(a)

1. REQUEST NO.

SPE7M1-18-Q-0883

2. DATE ISSUED

2018 SEP 04

3. REQUISITION/PURCHASE REQUEST NO.

0074278024

RATING

DO-C9

DLA LAND AND MARITIME

MARITIME SUPPLY CHAIN

PO BOX 3990

COLUMBUS OH 43218-3990

USA

Buyer: KALYN REDECKER PMCMKKV Tel: 614-692-9965 Email: KALYN.REDECKER@dla.mil

6. DELIVER BY (Date)

110 DAYS ADO

8. TO:

c. CITY

d. STATE

b. STREET ADDRESS

a. NAME OF CONSIGNEE

e. ZIP CODE

a. 10 CALENDAR DAYS

b. 20 CALENDAR DAYS (%) c. 30 CALENDAR DAYS

15. DATE OF QUOTATION

a. NAME (Type or Print)

AREA CODE

c. TITLE (Type or Print)d. CITY

c. COUNTY

b. STREET ADDRESS

e. STATE f. ZIP CODE

See Schedule

2018 SEP 17

NUMBER

FOB DESTINATION

OTHER

(See Schedule)

CAGE

b. TELEPHONE

See attached schedule to complete quote information.

Quoter must also complete the following:

a. Quotation is valid for 90 days from date specified in Block 10 above unless otherwise indicated: _____________ .

b. Prices quoted are:

___ Contained in Commercial Catalog or Published Price List No. ___________________ dated _______________ page __________ .

___ Contained in Internal Price List No. _______________dated ____________________, which may be examined at our facility.

___ Commercial sales of comparable quantities: Quantity ____________ ; Price _____________;

___ Customer ________________________.

___ Other (provide basis) ______________________________________ _______________________________________ .

c. FOB Point: ____ Destination ____ Origin Shipping Point (City, State) _________________________________________ .

d. If delivery period shown in Block 6 is unacceptable, provide best possible delivery: _________________________________.

e. Remittance Address (Name, Street, City, State, ZIP): Same as Block 13 unless otherwise indicated below:

f. Vendor FAX Number: ____________________ Vendor Toll-Free Number: ____________________ Vendor E-mail: ______________________________

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SPE7M1-18-Q-0883

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THIS SOLICITATION IS BEING ISSUED UNDER SEPA AUTHORITY.

THIS SOLICITATION INCORPORATES THE TERMS AND CONDITIONS SET FORTH IN THE REVISION OF THE DLA MASTER SOLICITATION FOR EPROCUREMENT AUTOMATED SIMPLIFIED ACQUISITIONS IN EFFECT ON THE SOLICITATION ISSUE DATE. ALL REVISIONS OF THE DLA MASTER SOLICITATION FOR EPROCUREMENT AUTOMATED SIMPLIFIED ACQUISITIONS CAN BE FOUND ON THE WEB AT: http://www.dla.mil/ HQ/Acquisition/Offers/eProcurement.aspx

DLAD PROCUREMENT NOTES

DLAD Procurement Notes are incorporated by reference, with the same force and effect as if they were in full text. The full text of a DLAD Procurement Note may be accessed electronically at http://www.dla.mil/HQ/Acquisition/Offers/ eProcurement.aspx and via 'References' on the DIBBS homepage.

FDT

This solicitation is issued under the First Destination Transportation (FDT) program to reduce the cost of transportation through the use of Government-arranged transportation utilizing Government contracts and rates. If this award is for FMS or has an APO/FPO ship-to address, these instructions do not apply.

For FDT Program Transportation Requirements, see Procurement Note C16 First Destination Transportation (FDT) Program, Government-Arranged Transportation for Manual Awards, C17 First Destination Transportation (FDT) Program – Shipments Originating from Outside the Contiguous United States, and Procurement Note C20 – Vendor Shipment Module (VSM).

Offers should be submitted based on FOB origin. For offerors whose shipments will originate from outside the contiguous United States, the offeror’s f.o.b. origin price shall include transportation to a contiguous United States location that the offeror selects based on cost-effectiveness or other variables at the offeror’s discretion.

Additional information about FDT can be found at http://www.dla.mil/LandandMaritime/Business/Selling/DLA-Land-and- Maritime-Procurement-Initiatives/FDTPI/

DFARS 252.232-7006 WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS (MAY 2013)

(a) Definitions. As used in this clause— “Department of Defense Activity Address Code (DoDAAC)” is a six position code that uniquely identifies a unit, activity, or organization.

“Document type” means the type of payment request or receiving report available for creation in Wide Area WorkFlow

(WAWF).

“Local processing office (LPO)” is the office responsible for payment certification when payment certification is done external to the entitlement system.

(b) Electronic invoicing. The WAWF system is the method to electronically process vendor payment requests and receiving reports, as authorized by DFARS 252.232-7003, Electronic Submission of Payment Requests and Receiving Reports.

(1) Have a designated electronic business point of contact in the System for Award Management at https://www.

acquisition.gov; and

(2) Be registered to use WAWF at https://wawf.eb.mil/ following the step-by-step procedures for self-registration available at this web site.

(d) WAWF training. The Contract or should follow the training instructions of the WAWF Web-Based Training Course and use the Practice Training Site before submitting payment requests through WAWF. Both can be accessed by selecting the “Web Based Training” link on the WAWF home page at https://wawf.eb.mil/

(e) WAWF methods of document submission. Document submissions may be via web entry, Electronic Data Interchange, or File Transfer Protocol.

(f) WAWF payment instructions. The Contractor must use the following information when submitting payment requests and receiving reports in WAWF for this contract/order:

(1) Document type. The Contractor shall use the following document type(s).

An invoice and WAWF receiving report (RR) are both required. The invoice and receiving report may be submitted separately or together as a combo type document. See DFARS Appendix F for detailed instructions on preparing the WAWF

RR.

NOTE: For contracts in accordance with Fast Payment Procedures, a Fast Pay (FP) invoice must be connected with a receiving report (RR), so either submit a FP combo or submit a RR and follow with a FP invoice. If there is no registered acceptor, the RR portion of the combo cannot be processed. In this case, submit a stand-alone FP invoice (“accept by” DoDAAC/location is mandatory).

(2) Inspection/acceptance location. The Contractor shall select the following inspection/acceptance location(s) in WAWF, as specified by the contracting officer.

See Award.

(3) Document routing. The Contractor shall use the information in the Routing Data Table below only to fill in applicable fields in WAWF when creating payment requests and receiving reports in the system.

Routing Data Table Field Name in WAWFData to be entered in WAWF Pay Official DoDAACSee Page 1 Issue By DoDAACSee Page 1 Admin DoDAACSee Page 1 Inspect By DoDAACSee Award Ship To CodeSee Award

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Ship From CodeSee Award/Purchase Order if applicable Mark For CodeSee Award/Purchase Order if applicable Service Approver (DoDAAC)See Award/Purchase Order if applicable Service Acceptor (DoDAAC)See Award/Purchase Order if applicable Accept at Other DoDAACSee Award/Purchase Order if applicable LPO DoDAAC DCAA Auditor DoDAAC Other DoDAAC(s)

(4) Payment request and supporting documentation. The Contractor shall ensure a payment request includes appropriate contract line item and subline item descriptions of the work performed or supplies delivered, unit price/cost per unit, fee (if applicable), and all relevant back-up documentation, as defined in DFARS Appendix F, (e.g. timesheets) in support of each payment request.

(5) WAWF email notifications. The Contractor shall enter the e-mail address identified below in the “Send Additional Email Notifications” field of WAWF once a document is submitted in the system.

Additional email notifications are not required.

(g) WAWF point of contact.

(1) The Contractor may obtain clarification regarding invoicing in WAWF from the following contracting activity’s WAWF point of contact.

Contact the local contract administrator found in block 6 of the DD 1155, block 9 of the SF 1449, or block 5 of the SF 26.

(2) For technical WAWF help, contact the WAWF helpdesk at 866-618-5988.

FAR 52.203-11 Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions

FAR 52.203-12 Limitation on Payments to Influence Certain Federal Transactions

DFARS 252.209-7004 Subcontracting with Firms that are owned or controlled by the government of a Terrorist country

FAR 52.222-35, Equal Opportunity for Veterans

FAR 52.222-37, Employment Reports on Veterans

FAR 52.223-9, Estimate of Percentage of Recovered Material Content for EPA-Designated Items

DFARS 252.225-7050, Disclosure of Ownership or Control by the Government of a Country that is a State Sponsor of Terrorism

FAR 52.203-12 LIMITATION ON PAYMENTS TO INFLUENCE CERTAIN FEDERAL TRANSACTIONS (OCT 2010)

DFARS 252.209-7004 SUBCONTRACTING WITH FIRMS THAT ARE OWNED OR CONTROLLED BY THE GOVERNMENT OF A TERRORIST COUNTRY.

DFARS 252.225-7001 Buy American

MANUAL EVALUATION: When automated evaluation is not used, as in the case of FAT and PLT requirements, or if the system is unable to make a fully automated award, quotations will be evaluated and awarded manually. When a quotation is manually evaluated, the contracting officer may consider quantity price breaks quoted without further discussion. When manually issued awards reference the Master Solicitation, all mandatory and conditional provisions, clauses, and procurement notes are incorporated by reference with the same force and effect as if set forth in full text.

OFFER SUBMISSION INSTRUCTIONS: ALL OFFERORS MUST SUBMIT THIER QUOTES THROUGH DIBBS . Once the evaluation process begins, late quotations will only be considered if the contracting officer determines that considering the late quotation is in the best interest of the Government and would not unduly delay the award.

EVALUATION FACTORS FOR AWARD “Award will be made to the offeror(s) whose quote(s) conforms to the solicitation requirements and represents the best value to the Government. Past performance, offered delivery and price will be evaluated when making a comparative assessment of quotes. An award may be made to other than the lowest priced, technically acceptable, responsible offeror(s)."

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SECTION B

SUPPLIES/SERVICES: 6105-01-245-8725

ITEM DESCRIPTION:

MOTOR,DIRECT CURRENT

RP001: DLA PACKAGING REQUIREMENTS FOR PROCUREMENT

RA001: THIS DOCUMENT INCORPORATES TECHNICAL AND/OR QUALITY REQUIREMENTS

(IDENTIFIED BY AN 'R' OR AN 'I' NUMBER) SET FORTH IN FULL TEXT IN THE

DLA MASTER LIST OF TECHNICAL AND QUALITY REQUIREMENTS FOUND ON THE WEB

AT: http://www.dla.mil/HQ/Acquisition/Offers/eProcurement.aspx. FOR

SIMPLIFIED ACQUISITIONS, THE REVISION OF THE MASTER IN EFFECT ON THE

SOLICITATION ISSUE DATE OR THE AWARD DATE CONTROLS. FOR LARGE

ACQUISITIONS, THE REVISION OF THE MASTER IN EFFECT ON THE RFP ISSUE DATE

APPLIES UNLESS A SOLICITATION AMENDMENT INCORPORATES A FOLLOW-ON

REVISION, IN WHICH CASE THE AMENDMENT DATE CONTROLS.

RQ002: CONFIGURATION CHANGE MANAGEMENT - ENGINEERING CHANGE PROPOSAL

REQUEST FOR VARIANCE (DEVIATION OR WAIVER)

RQ011: REMOVAL OF GOVERNMENT IDENTIFICATION FROM NON-ACCEPTED SUPPLIES

THIS ITEM HAS TECHNICAL DATA SOME OR ALL OF WHICH IS SUBJECT TO

EXPORT-CONTROL REGULATIONS. DISTRIBUTION OF THE TECHNICAL DATA AND

ELIGIBILITY FOR AWARD ARE LIMITED TO THOSE SUPPLIERS QUALIFIED THROUGH

JCP CERTIFICATION, OR TO THOSE LICENSED BY EITHER THE DEPARTMENTS OF

STATE OR COMMERCE; OR TO FOREIGN SUPPLIERS PURSUANT TO INTERNATIONAL

AGREEMENTS.

TO APPLY FOR JCP CERTIFICATION, COMPLETE DD FORM 2345, MILITARY CRITICAL

TECHNICAL DATA AGREEMENT, FORM IS AVAILABLE AT THE WORLD WIDE WEB

ADDRESS:

https://public.logisticsinformationservice.dla.mil/PublicHome/jcp/defaul t.aspx

OR BY WRITING TO:

DLA LOGISTICS INFORMATION SERVICE

FEDERAL CENTER

74 WASHINGTON AVE., NORTH

BATTLE CREEK, MI 49037-3084

TO MANUFACTURE THIS ITEM, NON-JCP CERTIFIED SUPPLIERS MUST SUBMIT A

CURRENT MANUFACTURING LICENSE AGREEMENT, TECHNICAL ASSISTANCE AGREEMENT,

DISTRIBUTION AGREEMENT OR OFF-SHORE PROCUREMENT AGREEMENT APPROVED BY

THE DIRECTORATE OF DEFENSE TRADE CONTROLS WITH THE OFFER, UNLESS AN

EXEMPTION UNDER THE PROVISIONS OF ITAR SECTION, 125.4 EXEMPTIONS OF

GENERAL APPLICABILITY, AND/OR EAR PART 740 ARE APPLICABLE.

NON-JCP CERTIFIED SUPPLIERS SEEKING EXPORT CONTROLLED TECHNICAL DATA ARE

REQUIRED TO PROVIDE THE CONTRACTING OFFICER WITH AN APPLICABLE AGREEMENT

OR IDENTIFY WHICH ITAR/EAR EXEMPTION APPLIES TO RECEIVE A COPY OF THE

EXPORT CONTROLLED TECHNICAL DATA.

NOTE: JCP CERTIFIED CONTRACTORS WHO RECEIVE TECHNICAL DATA PURSUANT TO

THEIR DD FORM 2345 CERTIFICATION MAY NOT FURTHER DISSEMINATE SUCH DATA

UNLESS FURTHER DISSEMINATION OF THE TECHNICAL DATA IS EXPRESSLY

PERMITTED BY DODD 5230.25.

DRAWINGS ARE SUBJECT TO EXPORT-CONTROL REGULATIONS

AND DISTRIBUTION IS LIMITED TO THOSE

CONTRACTORS WITH JCP CERTIFICATION.

CERTIFICATION IS MAINTAINED AT THE

DLA LOGISTICS INFORMATION SERVICE

IN BATTLE CREEK, MI.

TO ENSURE THAT ONLY JCP CERTIFIED CONTRACTORS RECEIVE AWARDS FOR

SOLICITATION ITEMS THAT ARE SUPPORTED BY EXPORT CONTROLLED TECHNICAL

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SECTION B

SUPPLY/SERVICE: 6105-01-245-8725 CONT'D

DATA, THE BUYER MUST CONFIRM THE CERTIFICATION PRIOR TO AWARD. THE JCP

HOME PAGE IS LOCATED AT THE FOLLOWING WEB ADDRESS:

https://public.logisticsinformationservice.dla.mil/PublicHome/jcp/defaul t.aspx

NOTE: THE CITED DRAWING IS A SOURCE CONTROLLED

DRAWING AND AS OF THE DATE OF THIS SOLICITATION

ONLY THE SOURCE(S) CITED ON THE DRAWING HAVE

BEEN APPROVED. EVEN THOUGH SOURCES AND APPROVED

PART NUMBERS ARE PROVIDED, THE ITEMS

FURNISHED MUST MEET THE REQUIREMENTS OF THE

CITED DRAWING. OFFERORS WHO ARE INTERESTED

IN QUALIFYING THEIR PRODUCT FOR PURPOSE OF

FUTURE ACQUISITION MUST CONTACT THE

COGNIZANT DESIGN ACTIVITY SPECIFIED ON THE

SOURCE CONTROLLED DRAWING.

ALSO, MAY INCLUDE ADDITIONAL APPROVED SOURCES

THAT HAVE NOT BEEN REFLECTED ON THE DRAWING AT

THIS TIME.

MERCURY OR MERCURY CONTAINING COMPOUNDS SHALL

NOT BE INTENTIONALLY ADDED TO<(>,<)> OR COME IN DIRECT

CONTACT WITH<(>,<)> ANY HARDWARE OR SUPPLIES FURNISHED

UNDER THIS CONTRACT. EXCEPTION: FUNCTIONAL MERCURY

USED IN BATTERIES, FLUORESCENT LIGHTS, REQUIRED

INSTRUMENTS; SENSORS OR CONTROLS; WEAPON SYSTEMS;

AND CHEMICAL ANALYSIS REAGENTS SPECIFIED BY NAVSEA.

PORTABLE FLUORESCENT LAMPS AND PORTABLE INSTRUMENTS

CONTAINING MERCURY SHALL BE SHOCK PROOF AND CONTAIN

A SECOND BOUNDARY OF CONTAINMENT OF THE MERCURY OR

MERCURY COMPOUND. (IAW NAVSEA 5100-003D).

THE INTERNATIONAL ORGANIZATION FOR STANDARDIZATION (ISO) 9001:2008 OR A

"TAILORED" PROGRAM MEETING THE FOLLOWING ISO 9001:2008 PARAGRAPHS

APPLIES:

4.2.4 CONTROL OF DOCUMENTS FOR INSPECTION AND TESTING AS WELL AS

APPLICABLE DRAWINGS SPECIFICATIONS AND INSTRUCTIONS REQUIRED BY THE

CONTRACT

7.4.2.A PURCHASING OF MATERIAL AND REQUIREMENTS FOR APPROVAL OF PRODUCT

7.5.1 AND 8.2.4 CONTROL OF PRODUCTION AND SERVICE PROVISIONS /

MONITORING AND MEASUREMENT OF PRODUCT

7.5.3 PRODUCT IDENTIFICATION AND TRACEABILITY

7.5.4 CUSTOMER PROPERTY (CUSTOMER SUPPLIED PRODUCT OR MATERIAL)

7.6 CONTROL OF MONITORING AND MEASURING EQUIPMENT

8.3 CONTROL OF NON-CONFORMING PRODUCT

8.5.2 AND 8.5.3 CORRECTIVE AND PREVENTATIVE ACTIONS

FAR CLAUSE 52.246-11 APPLIES

CRITICAL APPLICATION ITEM

Kollmorgen Corporation 11384 P/N QT-4604-A

IAW BASIC DRAWING NR 53711 5543190

REVISION NR J DTD 07/01/2015

PART PIECE NUMBER: 5543190-001

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SECTION B

SUPPLY/SERVICE: 6105-01-245-8725 CONT'D

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT .

0001 6105-01-245-8725 88.000 EA $ ________________ $ ________________

MOTOR,DIRECT

CURREN

QTY VARIANCE: PLUS 0% MINUS 0%

PREP FOR DELIVERY:

PKGING DATA-QUP:001

SHALL BE PACKAGED IN ACCORDANCE WITH ASTM D 3951.

Markings Paragraph When ASTM D3951, Commercial Packaging is specified, the following apply:

•,,All Section “D” Packaging and Marking Clauses take precedence over

ASTM D3951.

•,,In addition to requirements in MIL-STD-129, when Commercial Packaging is used, the Method of Preservation for all MIL-STD-129 marking and labeling shall be “CP” Commercial Pack.

•,,The Unit of Issue (U/I) and Quantity per Unit Pack (QUP) as specified in the contract take precedence over QUP in ASTM D3951.

PARCEL POST ADDRESS:

SW3218

DLA DISTRIBUTION SAN DIEGO

3581 CUMMINGS ROAD BLDG 3581

SAN DIEGO CA 92136-3581

FOR TRANSPORTATION ASSISTANCE SEE DLAD 52.247-9034. FOR FIRST DESTINATION TRANSPORTATION (FDT) AWARDS SEE DLAD

52.247-9059 AND CONTRACT INSTRUCTIONS INSTEAD.

FREIGHT SHIPPING ADDRESS:

SW3218

DLA DISTRIBUTION SAN DIEGO

3581 CUMMINGS ROAD BLDG 3581

SAN DIEGO CA 92136-3581

GOVT USE

External External External Customer RDD/ ITEM PR PRLI PR PRLI Material Need Ship Date .

0001 0074278024 0001 N/A N/A N/A 01/25/2019

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SECTION A - SOLICITATION/CONTRACT FORM

52.204-16 COMMERCIAL AND GOVERNMENT ENTITY CODE REPORTING (JUL 2016) FAR

SECTION I - CONTRACT CLAUSES

52.204-14 SERVICE CONTRACT REPORTING REQUIREMENTS (OCT 2016) FAR

52.204-15 SERVICE CONTRACT REPORTING REQUIREMENTS FOR INDEFINITE-DELIVERY CONTRACTS (OCT 2016) FAR

52.204-18 COMMERCIAL AND GOVERNMENT ENTITY CODE MAINTENANCE (JUL 2016) FAR

52.204-20 PREDECESSOR OF OFFEROR (JUL 2016) FAR

As prescribed in 4.1804(d), insert the following provision:

(a) Definitions. As used in this provision -

“Commercial and Government Entity (CAGE) code” means -

(1) An identifier assigned to entities located in the United States or its outlying areas by the Defense Logistics Agency (DLA) Commercial and Government Entity (CAGE) Branch to identify a commercial or government entity; or

(2) An identifier assigned by a member of the North Atlantic Treaty Organization (NATO) or by the NATO Support and Procurement Agency (NSPA) to entities located outside the United States and its outlying areas that the DLA Commercial and Government Entity (CAGE) Branch records and maintains in the CAGE master file. This type of code is known as a NATO CAGE (NCAGE) code.

“Predecessor” means an entity that is replaced by a successor and includes any predecessors of the predecessor.

“Successor” means an entity that has replaced a predecessor by acquiring the assets and carrying out the affairs of the predecessor under a new name (often through acquisition or merger). The term “successor” does not include new offices/divisions of the same company or a company that only changes its name. The extent of the responsibility of the successor for the liabilities of the predecessor may vary, depending on State law and specific circumstances.

(b) The Offeror represents that it [ ] is or [ ] is not a successor to a predecessor that held a Federal contract or grant within the last three years.

(c) If the Offeror has indicated “is” in paragraph (b) of this provision, enter the following information for all predecessors that held a Federal contract or grant within the last three years (if more than one predecessor, list in reverse chronological order):

Predecessor CAGE code:

Predecessor legal name:

(Do not use a “doing business as” name)

(End of provision)

SECTION K - REPRESENTATIONS, CERTIFICATIONS AND STATEMENTS

52.204-17 OWNERSHIP OR CONTROL OF OFFEROR (JUL 2016) FAR

As prescribed in 4.1804(b), use the following provision:

(a) Definitions. As used in this provision -

“Commercial and Government Entity (CAGE) code” means -

(2) An identifier assigned by a member of the North Atlantic Treaty Organization (NATO) or by the NATO Support and Procurement Agency

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SECTION K - REPRESENTATIONS, CERTIFICATIONS AND STATEMENTS (CONTINUED)

(NSPA) to entities located outside the United States and its outlying areas that the DLA Commercial and Government Entity (CAGE) Branch records and maintains in the CAGE master file. This type of code is known as a NATO CAGE (NCAGE) code.

“Highest-level owner” means the entity that owns or controls an immediate owner of the offeror, or that owns or controls one or more entities that control an immediate owner of the offeror. No entity owns or exercises control of the highest level owner.

“Immediate owner” means an entity, other than the offeror, that has direct control of the offeror. Indicators of control include, but are not limited to, one or more of the following: ownership or interlocking management, identity of interests among family members, shared facilities and equipment, and the common use of employees.

(b) The Offeror represents that it [ ] has or [ ] does not have an immediate owner. If the Offeror has more than one immediate owner (such as a joint venture), then the Offeror shall respond to paragraph (c) and if applicable, paragraph (d) of this provision for each participant in the joint venture.

Immediate owner CAGE code:

Immediate owner legal name:

(Do not use a “doing business as” name)

Is the immediate owner owned or controlled by another entity?: [ ] Yes or [ ] No.

(d) If the Offeror indicates “yes” in paragraph (c) of this provision, indicating that the immediate owner is owned or controlled by another entity, then enter the following information:

Highest-level owner CAGE code:

Highest-level owner legal name:

(Do not use a “doing business as” name)

(End of provision)

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